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APRIL 7th, 2005 – CHICAGO
Amelia is a young woman who hallucinates music continuously. It becomes apparent that something is amiss when she takes all her clothes out of the closet and donates them to Goodwill. She mails a handful of letters, then completes the rest of her to-do list. This is where the book begins.

Amelia attempts a graphic suicide. She survives.

In the hospital psych ward, she befriends a young man named Charlie. She also makes enemies. During the group therapy session, the nurse is kind and insightful, but talks to the patients as if they’re children. They open each session with a prayer. Amelia’s agnosticism and refusal to pray creates a rift with patients and staff. She explains the religious reasoning behind her self-injury, and we learn the extent of her psychosis.

The RPN prescribes Amelia a dose of Trazodone at night to help her sleep. Amelia is hesitant to take a psychiatric pill. Within minutes, the walls are spinning and the floor is warping. She ends up literally crawling to her bed, and passes out immediately. Auditory hallucinations still replace large swathes of time and conversation, which is a comfort and distraction.

Amelia’s father comes for his biweekly visit. They discuss God. He tells her that her family is furious. Amelia’s father recounts all the red flags he ignored over Amelia’s life, and apologizes to her. Another visitor comes to see Amelia: Her flat mate Constance. Constance relates news about the outrage of her friends and now-ex-fiancé. It seems everyone is against her.

Amelia finally sees her psychiatrist, who diagnoses her with Bipolar Type II – Hypomanic (dysphoric)- Severe with Psychotic Features. He clearly illustrates the difference between Bipolar One and Bipolar Two. Amelia spends days vomiting, choking down pills, and lying on the floor of the shower. We see her nightmares.


Amelia is now able to function, but she doesn’t hear music anymore. All everyday sounds are amplified. She still wants to die, but she no longer wants to kill herself. Without constant musical distraction, Amelia becomes attentive to the appearance and emotions of her fellow patients. The author’s writing style changes, and details that were missed, due to her obsession with music, come to the fore.


In group therapy, Nurse Jessica asks Amelia to explain her side-effects, and the positive effects of the medicine. Amelia describes her mind in detail, and mourns the loss of the music in her head. A patient suggests that she make her own music OUTSIDE her head to help cope with the loss of music inside her thoughts.

In art therapy, someone helps her unlock the piano while the therapist is on a bathroom break. The effect is immediate and intense. As Amelia plays, the entire room is just still. Everyone listens in rapture, quiet and calm.

The psychiatrist and Amelia have a long talk about the effects of her medication. She describes the experience of being on psychopharmaceuticals in detail. The doctor gives Amelia advice about how to handle her transition back into society. He explains what to do if a prescription is not working, and how to communicate with her doctor. He also offers solutions to deal with the noise of being without music.

When it’s time for Amelia’s discharge, she plays one last song on the piano. After she is done, each person bids her goodbye in their own way. Some give small tokens. Amelia leaves the ward with a clearer mind, and a new and destructive habit.


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